Suspected transmission of avian flu from person to person reported
The first documented case of probable human to human transmission of the avian influenza virus was reported this week (New England Journal
of Medicine 2005;352:333).
Asian researchers describe the case of an 11-year-old girl in Vietnam
who, after being exposed to dying chickens, became ill and died several
days later. The child’s mother, who lived in a different province,
came to look after the child and also died after
developing pneumonia but having had no known contact with poultry.
The girl’s aunt who lived in the same house also developed pneumonia
after looking after the child. The aunt had had no contact with poultry
for over two weeks. Autopsy tissue samples from the mother and nasopharyngeal
throat swabs from the aunt were both positive for influenza A (H5N1),
the avian flu virus. The researchers say that the women probably became
ill from direct person to person transmission of avian flu after contact
with the ill child.
However, because the disease was not transmitted to any other people
who had been in contact with the family, the researchers say that the
virus may not have adapted to efficient human spread. Furthermore, tests
on the viral genes provided no evidence that the gene had mutated. The
researchers warn that this should not trigger complacency, saying: “The
person to person transmission of one of the most lethal human pathogens
in the modern world should serve as a reminder of the urgent need to
prepare for a future influenza pandemic.”
The avian flu virus has infected at least 47 people in Asia since last
January, killing 34. No evidence of efficient person to person transmission
has yet been reported (PJ, 22 January, p76).
Research needs Klaus Stohr, co-ordinator of the World Health Organization
global influenza programme, outlined this week areas in which information
is urgently needed in light of a threatening flu pandemic. These
include case management and infection control, research on the immunogenicity
of vaccines and the role of bird and animal species in the epidemiology
of these viruses (New England Journal of Medicine 2005;352:405).
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